Purpose
To prepare clinicians with general knowledge and skills to work with patients suffering from motor apraxia as a result of Alzheimer’s type dementia. Objectives
The reader will understand the definition of motor apraxia as it pertains to populations with Alzheimer’s
The reader will learn to identify signs of motor apraxia.
The reader will learn the importance of individualized care for those suffering from Alzheimer’s type dementia.
The reader will learn specific techniques to promote participation in physical therapy and improve motor learning in people with motor apraxia as a result of Alzheimer’s.
Alzheimer’s Disease
Alzheimer’s Diseases is a progressive neurological condition that affects how people think and interact with people and their environment. Alzheimer’s is the most common form of dementia and influences a person’s ability to perform activities of daily living by altering memory, personality, decision-making, speech, judgment, movement, and many more components of cognition. In the US, it is estimated that 5% of people over 65 years of age and 40% over 85 years of age have Alzheimer’s disease. These numbers are expected to rise as the elderly population continues to grow. 42% of people living in assisted living facilities have Alzheimer’s or other types of dementia and of all Medicare beneficiaries living in a skilled nursing facility, 64% suffer from the same.1 A majority of facilities have established physical, occupational, and speech therapy programs available for their residents but the ability to treat those with Alzheimer’s or other types of dementia based on their specific needs is becoming more crucial. Motor Apraxia
Motor Apraxia is the inability to plan and carry out a learned movement even though the command was processed correctly. Breakdown in neural circuits, as seen in cortical dementias like Alzheimer’s, causes errors in movement production, inappropriate movements specific to commands, and the complete inability to perform a task.2 Alzheimer’s disease has been found to have the greatest association with motor apraxia as compared to other types of dementia.3 Approximately 35% of those suffering from Alzheimer’s disease demonstrate motor apraxia.4 Due to the unpredictable nature of apraxia limiting a person’s ability to mimic and produce movements based on command, rehabilitation can be a frustrating experience for both the patient and therapist. However, it is possible to teach motor skills to those dealing with apraxia.5 Therefore, it is essential that clinicians working with this population have adequate knowledge of teaching and treatment techniques in order to achieve rehab goals while dealing with apraxia.
Signs6
Difficulty performing tasks previously familiar to the patient
Hesitation with movement
Frustration when attempting to perform movement
Difficulty following broad commands
Unwillingness to participate in activities
Strategies for Treatment (alzonline.edu)
Be consistent with directions, giving them the same way each time
Give directions slowly and provide one step at a time
Utilize verbal and visual cues first and move towards tactile cues if no progress is made
Use part-whole practice
Practice simple movements first, progressing when learning is achieved
To prepare clinicians with general knowledge and skills to work with patients suffering from motor apraxia as a result of Alzheimer’s type dementia.
Objectives
- The reader will understand the definition of motor apraxia as it pertains to populations with Alzheimer’s
- The reader will learn to identify signs of motor apraxia.
- The reader will learn the importance of individualized care for those suffering from Alzheimer’s type dementia.
- The reader will learn specific techniques to promote participation in physical therapy and improve motor learning in people with motor apraxia as a result of Alzheimer’s.
Alzheimer’s DiseaseAlzheimer’s Diseases is a progressive neurological condition that affects how people think and interact with people and their environment. Alzheimer’s is the most common form of dementia and influences a person’s ability to perform activities of daily living by altering memory, personality, decision-making, speech, judgment, movement, and many more components of cognition. In the US, it is estimated that 5% of people over 65 years of age and 40% over 85 years of age have Alzheimer’s disease. These numbers are expected to rise as the elderly population continues to grow. 42% of people living in assisted living facilities have Alzheimer’s or other types of dementia and of all Medicare beneficiaries living in a skilled nursing facility, 64% suffer from the same.1 A majority of facilities have established physical, occupational, and speech therapy programs available for their residents but the ability to treat those with Alzheimer’s or other types of dementia based on their specific needs is becoming more crucial.
Motor Apraxia
Motor Apraxia is the inability to plan and carry out a learned movement even though the command was processed correctly. Breakdown in neural circuits, as seen in cortical dementias like Alzheimer’s, causes errors in movement production, inappropriate movements specific to commands, and the complete inability to perform a task.2 Alzheimer’s disease has been found to have the greatest association with motor apraxia as compared to other types of dementia.3 Approximately 35% of those suffering from Alzheimer’s disease demonstrate motor apraxia.4 Due to the unpredictable nature of apraxia limiting a person’s ability to mimic and produce movements based on command, rehabilitation can be a frustrating experience for both the patient and therapist. However, it is possible to teach motor skills to those dealing with apraxia.5 Therefore, it is essential that clinicians working with this population have adequate knowledge of teaching and treatment techniques in order to achieve rehab goals while dealing with apraxia.
Signs6
- Difficulty performing tasks previously familiar to the patient
- Hesitation with movement
- Frustration when attempting to perform movement
- Difficulty following broad commands
- Unwillingness to participate in activities
Strategies for Treatment (alzonline.edu)References
- Alzheimer’s Association. 2015 Alzheimer’s Disease Facts and Figures. Alzheimer’s & Dementia 2015;11(3)332+.
- Foundas AL. Apraxia: neural mechanisms and functional recovery. Handb Clin Neurol;2013 Jan 110:335-345
- Ozkan S, Adapinar DO, Elmaci NT, Arslantas D. Apraxia for differentiating Alzheimer’s disease from subcortical vascular dementia and mild cognitive impairment. Neuropsychiatric Disease and Treatment. 2013;9:947-951.
- Chandra SR, Issac TG, Abbas MM. Apraxias in Neurodegenerative Dementias. Indian J Psychol Med;2015 Jan 37:42-47
- Jacobs DH, Adair JC, Williamson DJ. Apraxia and motor-skill acquisition in Alzheimers disease are dissociable. Neuropsychologica;1999 June 37:875-880
- Bak TH. Why patients with dementia need a motor examination. J Neurol Neurosurg Psychiatry;2016 June EPub
Additional Resources